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A lot of people are ranting about LMCC 2, though I do personally see some of the utility of it for family medicine residents.  Our CCFP oral exams are basically testing our ability to carry out a glorified social history so I think there is some utility for family practice residents for doing the LMCC to show we have a good approach to common primary care scenarios and can take a proper history and physical.  

What I don't get is why other specialties are required to do this exam when they are going to be put through the ringer with their own Royal College Exams.  MCC has some statement on their website about ensuring high quality, generalist physicians. Is't that what a family doctor is?  Why does a vascular surgeon or pathologist need to be a good generalist physician?  I would think some specialties would have powerful enough lobbies to get the exam waived or something.

Finally, as it is now, family medicine residents (and to a much lesser extent emergency medicine residents) have a massive advantage on the exam.  The majority of the scenarios are straight out of a primary care office.  How many specialty residencies rotate through obs/gyne? Less than half? How about peds?  It seems like a lot of the candidates are doing stations they may not have done since third year med school.  It seems quit unfair, I am surprised there hasn't been a major backlash or uproar to have exam cancelled for Royal College programs (aside from premed101 rants).

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15 hours ago, medisforme said:

A lot of people are ranting about LMCC 2, though I do personally see some of the utility of it for family medicine residents.  Our CCFP oral exams are basically testing our ability to carry out a glorified social history so I think there is some utility for family practice residents for doing the LMCC to show we have a good approach to common primary care scenarios and can take a proper history and physical.  

What I don't get is why other specialties are required to do this exam when they are going to be put through the ringer with their own Royal College Exams.  MCC has some statement on their website about ensuring high quality, generalist physicians. Is't that what a family doctor is?  Why does a vascular surgeon or pathologist need to be a good generalist physician?  I would think some specialties would have powerful enough lobbies to get the exam waived or something.

Finally, as it is now, family medicine residents (and to a much lesser extent emergency medicine residents) have a massive advantage on the exam.  The majority of the scenarios are straight out of a primary care office.  How many specialty residencies rotate through obs/gyne? Less than half? How about peds?  It seems like a lot of the candidates are doing stations they may not have done since third year med school.  It seems quit unfair, I am surprised there hasn't been a major backlash or uproar to have exam cancelled for Royal College programs (aside from premed101 rants).

The real bullshit IMO is that you cant do anything with it.  I truly think that if you pass an exam saying you have been ensured to be a quality generalist physician...I should have been able to moonlight in walk-in clinics during my residency for extra money.  I still have not gotten a good answer as to why that isn't true, other than that they exam actually tests nothing and the "high quality generalist physician" thing is just a façade.

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6 hours ago, ellorie said:

No motivation for staff who have already passed it to lobby too hard against it and it’s probably a huge source of revenue. 

Mostly I’m pissed that I paid them all that money and the best they could give me for lunch was a cruddy tuna sandwich and some stale vegetable pieces. 

...you got lunch?

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25 minutes ago, rmorelan said:

some do - there are centre and provincial rules about that. It is relatively rare of course. 

 

From when I was a resident in Toronto you essentially needed sign off from your program director--because technically moonlighting is a violation of your employment contract, which states that you can only practice under supervision as part of a residence program.  This never happened to anyone I knew or heard of.  Apparently (~5-10 years) ago there was a resident who was able to essentially do it at a known unpleasant hospital, and justified it by saying they really needed the help.

Then you need to get an independent license from the CPSO (which is over $2000). 

Again since its technically against the employment contract (without a special program director amendment) its almost never done.  And theres no way you could just casually moonlight at a random walk in clinic (which is what I'm suggesting you should be able to do with the LMCC2).  Its a major process.

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1 minute ago, goleafsgochris said:

From when I was a resident in Toronto you essentially needed sign off from your program director--because technically moonlighting is a violation of your employment contract, which states that you can only practice under supervision as part of a residence program.  This never happened to anyone I knew or heard of.  Apparently (~5-10 years) ago there was a resident who was able to essentially do it at a known unpleasant hospital, and justified it by saying they really needed the help.

Then you need to get an independent license from the CPSO (which is over $2000). 

Again since its technically against the employment contract (without a special program director amendment) its almost never done.  And theres no way you could just casually moonlight at a random walk in clinic (which is what I'm suggesting you should be able to do with the LMCC2).  Its a major process.

definitely is - I know people outside of Ontario that have moonlighted in small ICUs etc during residency once they have done enough of their training. 

anyway quite rare - and as much as money is useful, I think it can be dangerous in terms of risk of burnout. You are already working crazy hours, and now there is even more :)

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On 12/6/2017 at 7:10 AM, medisforme said:

Most of the negative feedback on here seems to be from specialty residents (which is completely understandable).  I was just curious if FM residents feel the same way or if (like me) you see some utility of the exam for our specialty.

Every single station I had on part 2 I have seen in either an FM clinic or in an ER during my residency. Part 2 was easier than my med school OSCEs mainly because I had way more knowledge and experience in FM cases by the time I was a second year FM resident compared to a 3rd or 4th year med student.

Part 2 covered aspects of the physical exam and diagnostics, whereas the CCFP exam covered interpersonal skills, medical and non-medical management, and history taking through written and interview components. For generalist residents I think there is merit to part 2, but I don't really understand it for specialty residents. All that generalist stuff was already tested for 4th year students in part 1 in written format.

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